IGalvus Met iyindlela entsha yokwelapha isifo sikashukela, izithako ezisebenzayo kuyo yi-vildagliptin ne-metformin. Umuthi ungathuthukisa kakhulu i-glycemia: eqenjini lokulawula unyaka wokuphatha, wasiza ukunciphisa i-hemoglobin ye-glycated ngo-1.5%. Ukuthatha la maphilisi kwenza ukwelashwa kwesifo sikashukela kuphephe kakhulu ngokunciphisa inani le-hypoglycemia ngezikhathi ezingama-5.5. Ama-95% eziguli ezigulile ayenelisekile ngempatho futhi ahlela ukuyilandela ngokuqhubekayo.
IGalvus ingenye indlela yesidakamizwa, iqukethe i-vildagliptin kuphela. Amathebulethi angahlanganiswa ne-metformin, i-sulfonylurea derivatives, i-insulin therapy.
Imiyalo yokusebenzisa
Isenzo sikaGalvus sisuselwa emiphumeleni yama-incretins. Lawa ama-hormone ahlanganiswa emzimbeni ngemuva kokudla. Zivusa ukukhululeka nokudedelwa kwe-insulin. IVildagliptin ekwakhiweni kweGalvus yandisa isenzo somunye wama-incretin - i-glucagon-like peptide-1. Ngokwesigaba semithi, le nto ingeyama-DPP-4 inhibitors.
Umuthi ukhiqizwa yinkampani yaseSwitzerland iNovartis Pharma, wonke umjikelezo wokukhiqiza useYurophu. IVildagliptin ibhalisiwe ebhukwini lezidakamizwa laseRussia muva nje, ngonyaka we-2008. Eminyakeni eyishumi eyedlule, isipiliyoni esiphumelelayo ekusebenziseni umuthi sekunqwabelene, safakwa ohlwini olubalulekile.
Ngokwe-theory, manje noma ngubani onesifo sikashukela onesifo sohlobo 2 angakuthola mahhala. Empeleni, ukuqokwa okunjalo akuvamile, ngoba umuthi ubiza kakhulu. Ukwelashwa okujwayelekile konyaka weGalvus ngama-ruble ayi-15,000. kubiza kakhulu kunokujwayelekile.
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
| Isenzo | Ilawula i-carbohydrate metabolism kusuka ezinhlangothini eziningana: ithuthukisa ukuhlanganiswa kwe-insulin, inciphisa ukufihlwa kwe-glucagon, yehlisa ukudonsa kwe-glucose yamathumbu, inciphisa isifiso sokudla, ivikele ama-pancreas, ibambezele ukufa kwamangqamuzana e-beta futhi ivuselele ukukhula okusha. I-Metformin njengengxenye yeGalvus Meta inciphisa ukumelana ne-insulin, ivimbela ukwakheka kwe-glucose esibindini nokungena kwayo iphuma nokugaya ukudla. UGalvus uyakwazi ukuthuthukisa iphrofayili ye-lipid yegazi, ngokuhlangana ne-metformin, lesi senzo sithuthukiswa kakhulu. I-bioavailability yesidakamizwa ifinyelela kuma-85%, ayiguquki ngokuya ngesikhathi sokudla. Ngokusho kwemiyalo esetshenzisiwe, inani eliphakeme lento esegazini lenzeka ngemuva kwemizuzu engu-105, uma amaphilisi ethethwe ngesisu esingenalutho, kuthi ngemuva kwemizuzu engu-150, uma kungokudla. Iningi le-vildagliptin lithululelwa emchameni, cishe nge-15% ngomgudu wokugaya ukudla, i-metformin ikhishwa ngokuphelele yizinso. |
| Izinkomba | Thayipha isifo sikashukela sesi-2. Ukwelashwa kwe-Galvus akukuqedi ukudla kanye nemfundo yomzimba. Ingasetshenziswa njengengxenye yokwelapha okuyinkimbinkimbi, ayisetshenziselwa uhlobo 1 lwesifo sikashukela kanye ne-ketoacidosis. |
| Contraindication | Ukuphikisana okuphelele kungukungaphenduki komzimba ezingxenyeni zomuthi. Ukwakheka kwamathebhulethi kufaka phakathi i-lactose, ngakho-ke akunconywa ngokuntuleka kwe-lactase. IGalvus ayibekelwe izingane, ngoba umphumela wayo emzimbeni wezingane awukafundwa. Ukuze kusetshenzwe okujwayelekile, uGalvus kumele akhiqizwe ngendlela yesikhathi futhi akhishwe emzimbeni. Ngaphambi kokuqala ukuthatha amaphilisi, iziguli ezinesifo sikashukela esinesibindi sokulimala nokusebenza kwezinso kufanele ziye kohlolwa okwengeziwe. Ukwemukelwa kukaGalvus Meta kuyenqatshelwe ukuphuma komzimba, i-hypoxia, izifo ezithathelwanayo ezinzima, izinkinga ezinzima zesifo sikashukela, ukudakwa. Amathebulethi akhanselwa okwesikhashana ngesikhathi sokungenelela kokuhlinzwa, ukudakwa kotshwala, ukwethulwa kwezinto ezine-radiopaque. |
| Ukulawulwa kwempilo | Ngenxa yokuthi iGalvus ingathinta ukusebenza kwesibindi, imiyalo yokusebenzisa itusa ukuthi ngesikhathi sokuphatha kwayo, qinisa ukulawulwa kwezempilo. Ngaphambi kokuthatha amaphilisi, kungakuhle ukuthi uthathe izivivinyo zesibindi: ukuhlolwa kwegazi nge-AcAt ne-AlAt. Izifundo ziphindwa njalo ngekota ngonyaka wokuqala wokwamukelwa. Uma imiphumela yokuhlolwa kwesibindi iphakeme kathathu kunokwejwayelekile, uGalvus kumele akhanseliwe. IGalvus Met ikhulisa ubungozi be-lactic acidosis. Lesi simo sihambisana nokufushane komoya, izinhlungu emisipha nasesiswini, ukwehla kwezinga lokushisa. Iziguli ezine-lactic acidosis zidinga ukulashwa ngokuphuthumayo esibhedlela. |
| Ukukhetha kwedosi | Ithebhulethi ngayinye yeGalvus iqukethe ama-50 mg we-vildagliptin. Phuza amaphilisi 1 noma amabili ngosuku. Umthamo uncike ekujuleni kwesifo sikashukela. IGalvus Met nayo ayivunyelwe ngaphezu kwamacwecwe ama-2. Kufika ku-1000 mg ye-metformin engezwe kuthebhulethi ngayinye. Isibonelo, kuGalvus Met 50 + 1000 mg: vildagliptin 50, metformin 1000 mg. Umthamo we-metformin ukhethwa ngokuya nge-glycemia. |
| Ukweqisa | Ukweqiwa okuphindwe kane komthamo ovunyelwe kakhulu kubangela i-edema, umkhuhlane, ubuhlungu bemisipha, nokuphazamiseka kwezinzwa I-overdose enamawundi ayisithupha igcwala ukwanda kokuqukethwe kwama-enzyme namaprotheni egazini. I-overdose yeGalvus Meta iyingozi ye-lactic acidosis. Lapho uthatha ngaphezu kwe-50 g ye-metformin, ukuqina kuvela ku-32% yeziguli. I-overdose iphathwa ngendlela ebonakalayo, uma kunesidingo, umuthi ukhishwa egazini usebenzisa i-hemodialysis. |
| Imiphumela emibi | UGalvus ubangela ukusabela okuphansi okumbalwa. Imiphumela emibi eminingi imnene futhi ingeyesikhashana, ngakho-ke, ayidingi ukuqedwa kwamathebulethi. Izinkinga ezingaba khona: <10% yeziguli - isiyezi, <1% - ikhanda, ukuqunjelwa, ukuvuvukala kwemikhawulo, <0.1% - ukungasebenzi kahle kwesibindi. Izibalo zemiphumela emibi yeGalvus Meta, ngaphezu kokwephulwa okungenhla, ifaka nomphumela ongathandeki obangelwe yi-metformin:> 10% - isicanucanu noma ezinye izinkinga zokugaya ukudla, <0.01% - ukusabela kwesikhumba, i-lactic acidosis, i-B12 anemia. |
| Ukukhulelwa kanye ne-GV | Idatha yokulinga kokuqala ikhombisa ukuthi uGalvus akaphazamisi ukukhula okujwayelekile kwesibeletho, kepha ulwazi olwanele lokusebenzisa umuthi alikakabuthwa. Ucwaningo lokuthi kungenzeka ukungena kwe-vildagliptin kubisi akukwenziwanga yini. Ngenxa yokushoda kolwazi umyalo wenqabela ukusetshenziswa kwe-Galvus ngesikhathi sokukhulelwa nokondla. |
| Ukusebenzelana kwezidakamizwa | Azange kube namacala wokuxhumana kwe-vildagliptin nezinye izidakamizwa. I-Metformin ingashintsha ukusebenza ngenkathi ikuthatha ngama-hormone, amaphilisi okucindezela kanye nezinye izidakamizwa ezidumile (uhlu oluphelele luyatholakala emiyalweni). |
| Ukwakheka kwamathebulethi | I-Vildagliptin noma i-vildagliptin + metformin, i-lactose, iselulose, i-magnesium stearate, i-titanium dioxide, i-talc. |
| Isitoreji | UGalvus - iminyaka emi-2, iGalvus Met - izinyanga eziyi-18. |
UGalvus Met
I-Metformin iyisidakamizwa emhlabeni jikelele sesifo sikashukela sohlobo 2, sinqunyelwe cishe kuzo zonke iziguli. Isikhathi eside sokusetshenziswa, hhayi kuphela ukusebenza kwalo muthi okuqinisekisiwe, kodwa futhi bathola imiphumela eminingi enenzuzo enhliziyweni, emithanjeni yegazi, ku-blood lipid spectrum. Ngokwezincomo zenhlangano yezazi zesifo sikashukela, ezinye izidakamizwa zichazwa kuphela lapho i-metformin inganele ukunxephezela isifo sikashukela.
Amaphilisi we-Galvus Met ahlanganisiwe, aqukethe i-metformin ne-vildagliptin. Ukusetshenziswa kwomuthi kunganciphisa isibalo samathebulethi, okusho ukuthi kunciphisa ubungozi bokushoda kuwo. Ububi bomuthi yizindleko eziphakeme zokwelashwa ngokuqhathaniswa nedosi elihlukile le-Galvus ne-metformin.
| Imithamo Galvus Met, mg | Intengo emaphakathi yamathebhu angama-30, ama-ruble. | Intengo yamathebulethi angama-30 kaGalvus neGlucofage yedosi elifanayo, ama-ruble. | Inzuzo yamanani,% |
| 50+500 | 1550 | 875 | 44 |
| 50+850 | 890 | 43 | |
| 50+1000 | 950 | 39 |
Ama-analog namagama
Njengoba uGalvus ewumuthi omusha, ukuvikela amalungelo obunikazi kusasebenza kuye. Abanye abakhiqizi abakwazi ukukhiqiza amaphilisi ngesithako esifanayo esisebenzayo, ama-analogues ashibhile wasekhaya awekho.
Ama-inhibitors we-DPP-4 nama-incretin mimetics angasebenza njengababambeli bakaGalvus:
- sitagliptin (Januvius, Xelevia, Yasitara);
- saxagliptin (Onglisa);
- I-Exenatide (Baeta);
- liraglutide (Viktoza, Saksenda).
Bonke laba abalingani bayabiza, ikakhulukazi iBaeta, Viktoza neSaksenda. Umuthi okuyiwona kuphela waseRussia ongaphezulu uyi-Yasitar ovela ku-Pharmasintez-Tyumen. Umuthi wabhaliswa ngasekupheleni kuka-2017, awukatholakali kumakhemisi.
Uma isiguli silandela ukudla, sithatha i-Galvus Met ngethamo elikhulu, noshukela usengaphezu kwesejwayelekile, lapho-ke ama-pancreas asondele kakhulu ekukhathaleni. Kulesi simo, ungazama ukukhuthaza ukwakheka kwe-insulin ngokutholakala kwe-sulfonylurea, kepha ngokunokwenzeka, kuzosebenza ngokungasebenzi. Uma i-insulin yakho isiphelile ukukhiqizwa, umuntu onesifo sikashukela udinga ukwelashwa esikhundleni se-insulin. Musa ukuhlehlisa ukuqala kwayo. Izinkinga zeshukela zikhula ngisho nangoshukela omncane.
UGalvus Met noma uYanumet
Zombili lezi zidakamizwa ziqukethe ama-hypoglycemic agents aqhamuka eqenjini elifanayo: Galvus Met - vildagliptin nge-metformin, uJanumet - sitagliptin nge-metformin. Bobabili banezinketho zemithamo efanayo nezindleko eziseduze: amaphilisi angama-56 eYanumet - ama-ruble angama-2600, ithebhu engama-30. UGalvus Meta - ama-ruble ayi-1550. Njengoba banciphisa ngokulinganayo i-hemoglobin ye-glycated, ukusebenza kwabo kubhekwa njengokulingana. Le mishanguzo ingabizwa ngokuthi ama-analogues asondele kakhulu.
Umehluko wezidakamizwa:
- I-Vildagliptin ithuthukisa iphrofayili ye-lipid yegazi, ngaleyo ndlela inciphise ingozi ye-angiopathy, i-sitagliptin hhayi nje kuphela ukuthi ibe nomphumela omuhle, kodwa futhi ingandisa i-cholesterol.
- I-Metformin ayibekezeleleki kahle, uma ithathwa, imiphumela emibi esegodini lokugaya ukudla iyaboniswa. Indlela yesikhathi eside ye-metformin isiza ukuthuthukisa ukubekezelelana. Iyingxenye yezibhebhe zeYanumet Long. IGalvus Met neYanumet ziqukethe i-metformin ejwayelekile.
UGalvus noma iMetformin
EGalvus Mete, izinto ezisebenzayo ziyalingana. Zombili zithinta amazinga kashukela, kepha zifeza isenzo sazo ngama-engeli ahlukile. I-Metformin - ikakhulukazi ngenxa yokwehla kwe-insulin ukumelana, i-vildagliptin - ukwanda kokuhlanganiswa kwe-insulin. Ngokwemvelo, umphumela we-multifactorial enkingeni usebenza kakhudlwana. Ngokwemiphumela yokulinganisa, ukungezwa kweGalvus ku-metformin kwehlisa i-glycated hemoglobin ngo-0.6% ezinyangeni ezi-3.
Akuwenzi mqondo ukunquma ukuthi iGalvus noma i-metformin ingcono. I-Metformin ithathwa ekuqaleni kwalesi sifo kanye nokudla nemidlalo, yezidakamizwa, iGlucofage yasekuqaleni noma uhlobo oluhle kakhulu lweSiofor luyathandwa. Lapho akwanele, iGalvus yengezwa kwirejimeni yokwelashwa noma kwi-metformin emsulwa ye-Galvus Metomet.
Okunye okungabizi ku-Galvus
Amaphilisi ashibhile kuneGalvus, kepha lawo aphephile futhi asebenzayo awekho. Unganciphisa ukukhula kwesifo sikashukela ngokuziqeqesha njalo, ukudla okune-carb ephansi, kanye ne-metformin eshibhile. Ukuthola isinxephezelo sesifo sikashukela, ezinye izidakamizwa ezinde ngeke zisadingeka.
Amalungiselelo we-urea owaziwa kakhulu nge-sulfonyl, njengoGalvus, akhuthaza ukwakheka kwe-insulin. Lokhu kufaka i-Maninil eqinile, kepha engaphephile, i-Amaryl ne-Diabeteson MV yesimanje. Azinakuthathwa njengezichasiso zikaGalvus, ngoba indlela yokusebenza yezidakamizwa ihluke kakhulu. Ama-Derivatives we-sulfonylureas akhuthaza i-hypoglycemia, agcwale ama-pancreas, asheshise ukubhujiswa kwamangqamuzana e-beta, ngakho-ke uma uwathatha, kufanele ulungele iqiniso lokuthi eminyakeni embalwa uzodinga ukwelashwa kwe-insulin. UGalvus uvimbela ukufa kwamaseli e-beta, enwebisa ukusebenza kwamanyikwe.
Imithetho Yokwamukela
I-Dose Enconyiwe yeVildagliptin:
- I-50 mg ekuqaleni kokuphatha, lapho isetshenziswa ndawonye namalungiselelo we-sulfonylurea, bathatha isibhebhe ekuseni;
- I-100 mg yesifo sikashukela esibuhlungu, kubandakanya nokwelashwa kwe-insulin. Umuthi uhlukaniswe ngemithamo emibili.
Kwi-metformin, umthamo ophelele ngu-2000 mg, okuphezulu yi-3000 mg.
UGalvus ungadakwa kokungenalutho noma esiswini esigcwele, iGalvus Met - kuphela ngokudla.
Ubungozi obuncishisiwe bemiphumela emibi
Ngokusho kwesifo sikashukela, iGalvus Met ibekezelelwa kangcono kune-metformin emsulwa, kodwa futhi ibuye ibangele izinkinga zokugaya ukudla: isisu, ukugabha nokuphazamiseka esiswini. Ukwenqaba ukwelashwa ngezimpawu ezinjalo akukufanele. Ukuze unciphise ubunzima bemiphumela emibi, udinga ukunika isikhathi somzimba ukuzivumelanisa nomuthi. Ukwelashwa kuqala ngomthamo omncane, kancane kancane kukhulisa kakhulu.
I-algorithm ecishe ilingane yokwandisa umthamo:
- Sithenga iphakethe leGalvus Met lomthamo omncane kakhulu (50 + 500), ngesonto lokuqala sithatha ithebhulethi eyi-1.
- Uma kungekho zinkinga zokugaya, siguqukela kudosi eliphindwe kabili ekuseni nakusihlwa. Awukwazi ukuphuza i-Galvus Met 50 + 1000 mg, naphezu komthamo ofanayo.
- Lapho ipakethe seliphelile, thenga ama-50 + 850 mg, uphuze amaphilisi ama-2.
- Uma ushukela usengaphezu kokujwayelekile, ngemuva kokuphela kokufakwa, sishintshela ku-Galvus Met 50 + 1000 mg. Awusoze wakhulisa umthamo futhi.
- Uma isinxephezelo sikashukela singanele, sengeza i-sulfonylurea noma i-insulin.
Iziguli ezikhuluphele ezinesifo sikashukela ziyalulekwa ukuthatha umthamo omkhulu we-metformin. Kulokhu, kusihlwa, baphuza futhi i-Glucofage noma iSiofor 1000 noma i-850 mg.
Uma ushukela wokuzila uphakanyisiwe, futhi ngemuva kokudla kaningi ngaphakathi kwemikhawulo ejwayelekile, ukwelashwa kungalungiswa: phuza iGalvus kabili, ne-Glucofage Long - kanye kusihlwa umthamo we-2000 mg. I-Glucofage enwetshiwe izosebenza ngokuzikhandla ubusuku bonke, ngaleyo ndlela iqinisekise i-glycemia ejwayelekile ekuseni. Ingozi ye-hypoglycemia ayikho.
Ukuhambisana notshwala
Emiyalweni kaGalvus, utshwala abukhulunywa, okusho ukuthi utshwala abuthinti ukusebenza kahle kwamathebhulethi futhi awukhulisi imiphumela emibi. Kepha uma usebenzisa i-Galvus Meta, ukudakwa notshwala kuyaphulwa, ngoba kukhulisa kakhulu amathuba okuba ne-lactic acidosis. Ngaphezu kwalokho, ukuphuza utshwala obujwayelekile, noma ngamanani amancane, kubhebhethekisa isinxephezelo sikashukela. Ukuphuza utshwala okungajwayelekile kubhekwa njengokuphephile uma izinga lokudakwa lincane. Ngokwesilinganiso, yi-60 g yotshwala kwabesifazane kanye nama-90 g kwabesilisa.
Umphumela kwesisindo
IGalvus Met ayinawo umthelela oqondile kwesisindo, kepha zombili izithako ezisebenzayo ekubunjweni kwayo zithuthukisa imetabolism yamafutha futhi inciphise iphango. Ngokusho kokubuyekezwa, ngenxa ye-metformin, iziguli ezinesifo sikashukela zingalahlekelwa amakhilogremu ambalwa. Imiphumela emihle ingeyabantu abanesifo sikashukela abanesisindo esiningi ngokweqile futhi baphikiswa ukumelana ne-insulin.
